Change 1: Changes to the assessment of Communication and Interpersonal Skills (CIS) component
The primary components of the scoring system are:
A) The Integrated Clinical Encounter or ICE subcomponent
B) The Communication and Interpersonal Skills or CIS subcomponent
C) The Spoken English Proficiency or SEP component
A) The ICE component includes
1) Data gathering (the questions you ask and physical exam)
2) Documentation (patient note)
B) The CIS component previously had 3 sections:
1) Questioning skills
2) Information sharing skills
3) Professional manner and rapport
2) Information sharing skills
3) Professional manner and rapport
But now it has 5 sections:
1) Fostering the relationship
2) Gathering information
3) Providing information
4) Making decisions: basic
5) Supporting emotions: basic
2) Gathering information
3) Providing information
4) Making decisions: basic
5) Supporting emotions: basic
C) The SEP component evaluates clarity of spoken English communication within the context of the doctor-patient encounter (e.g. pronunciation, word choice, and minimizing the need to repeat questions or statements)
Change 2: Changes to the patient note:
In the new note, examinees need to continue to document relevant history and physical examination findings and to list initial diagnostic studies to be ordered like previous patient note. In addition, examinees will also be asked to create a reasoned, focused differential (maximum of three expected diagnoses) listed in order of likelihood and to indicate the evidence obtained from the history and physical examination that supports (or refutes) each potential diagnosis.
A sample patient note as available from the USMLE website is shown below.
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| Please click the image to enlarge |